Fishburn Hedges

01.04.2011

This week sees the Health and Social Care Bill come to the end of its Committee session in the House of Commons, where MPs have debated and discussed its merits in detail. While this part of the parliamentary procedure is supposed to be an opportunity for making changes, alterations and amendments to a Bill, the reality is that in this particular case the Health Bill has so far emerged relatively unscathed.

For anyone with a vague interest in the issue this might come as something of a surprise. Unless you’ve been living in a black hole for the last couple of months, you can’t have failed to notice the outcry and anger that the Bill has provoked amongst the healthcare community.

The British Medical Association took it upon themselves to organise a special emergency meeting calling for the Health Bill to be scrapped, while there has been a stream of negative comments from the likes of the RCGP and Unison. Only yesterday, the NHS Confederation has come out calling on the government to produce “a compelling narrative” to explain the direction of reforms.

For all these external grumblings, however, Andrew Lansley has, to date, remained steadfast and firm. Granted he’s had to go on the record and clarify one or two things and in recent weeks we’ve seen him temper his rhetoric on competition (“any willing provider” is now “any qualified provider”) but for the moment he seems to be digging his heels in.

The question remains, however: how long can this stand-off between the Secretary of State and those at pains to criticise the Bill last? Yesterday’s Times suggests that No.10 is becoming increasingly nervous and is seeking external advice on whether to slow-down the pace of reform. The Lib Dems are also on something of a warpath, gunning for the Bill to be watered down following a vote at their Spring Conference.

While I suspect that no one really knows the answer – a significant u-turn would be yet another major embarrassment for the government – we are likely to see a number of concessions and the possibility of amendments tabled when the Bill reaches the House of Lords in May. I have a sneaky suspicion as well that Lansley’s days may be numbered. Come the inevitable summer reshuffle, we may find ourselves with a new Secretary of State whose job it is to sell the reform vision.

And it is this – ‘the sell’ - that gets us to the heart of why the government has found itself in this mess in the first place. The Department of Health failed to test or really consult on the reforms before publishing the Bill (you’ll recall that there was absolutely no wind of it in the Conservative’s election manifesto) and has fallen significantly short in explaining or communicating the benefits. As any good PR will tell you, knowing your audience, crafting the right message, and having a compelling story is – and always will be - absolutely key.

Posted by Holly Rouse